Sources of Psychiatric Ethics
Ethics and law are closely related, but they are
not synonymous (Ellis, 1991). Courts and legislatures attempt to embody
ethi-cal principles in their creation and interpretation of law. But not every
ethically supportable course of conduct is, or should be, codified in the form
of mandatory or prohibitory legal provisions backed up by the government’s
authority to punish, and not every legal mandate is consistent with medical
ethics.
It is beyond the scope to deal comprehensively with
the ethical codes established by the world’s various reli-gions. Suffice it to
say that many ethical decisions that confront psychiatrists have their roots in
religion. Indeed, almost to the end of the 19th century, the treatment of
mental disorders was conducted, to a great extent, under the auspices of
religious insti-tutions or at least in concert with the prevailing religious
ideas of the time. Today’s issues include treatment refusal, abortion and end
of life decisions, among many others. Psychiatrists must be sensitive to the
impact that their own and their patients’ religious beliefs have on their
understanding of human behavior.
One of the hallmark characteristics of a learned
profession is its development and adoption of a unique code of ethics to guide
its practitioners. The APA has adopted such a code since 1989. Although
“psychiatrists are assumed to have the same goals as all physicians’’, these
principles have been revised “with anno-tations especially applicable to
psychiatry’’. The rationale was that “there are special ethical problems in
psychiatric practice that differ in coloring and degree from ethical problems
in other branches of medical practice’’ (Table 6.9).
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